HNF Stories

10:39 pm

Mon February 10, 2014

On Medicaid, FMA Punts Again

The Florida Medical Association’s Board of Governors turned aside a resolution in support of Medicaid Expansion last weekend, sending it to a committee. While FMA did not say that effectively kills it for this legislative session, its supporters did.

“I am disappointed and disagree with tabling it, and disagree with the politics involved, which in essence will keep the status quo while patients, physicians and hospital suffer the consequences,” said Dr. Aaron Elkin of Hollywood, sponsor of the resolution.

Elkin, a past president of the Broward County Medical Association, isn’t giving up; he’s looking toward forming a coalition of groups that care about the issue.

“You should never stop advocating for what’s right,” he said. “We will not go away.”

At stake is insurance coverage for almost 1 million low-income Floridians who were to have received Medicaid on Jan. 1, through the Affordable Care Act. And an estimated $51 billion in federal funds that would cover most of the cost for the first 10 years of the program, starting with 2014.

But the Supreme Court said that since Medicaid is a joint state-federal program, states had to agree for the expansion to go forward. And Florida didn’t.

When the Legislature met last spring, Gov. Rick Scott and the Senate said they supported taking the federal funds if the Obama administration would allow Florida to use private health plans for the new Medicaid population. Federal health officials indicated they would.

But one man – House Speaker Will Weatherford – blocked the action, saying he didn't trust the federal government. He told Republican House members they had to vote no, and all but one did.

So that left Florida in an odd position: Uninsured people who have incomes above the poverty level, between 100 and 400 percent, now qualify for subsidized plans on Healthcare.gov. But those below the poverty level are left out.

The same thing is true of many other states, including Texas. But in that state, the Texas Medical Association is lobbying on behalf of expanding coverage.

In Florida, the Medical Association is officially “neutral,” said spokeswoman Erin Vansickle.

What had given Elkin and others hope for change is that an FMA advisory committee that studied the issue backed Medicaid expansion as long as doctors who treat Medicaid patients were given a pay boost. Elkin’s resolution called for treatment of Medicaid patients to equal that for Medicare patients, a concept called “parity.”

This summer, when the FMA’s House of Delegates holds its annual meeting, the subject will doubtless resurface.